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Orthostatic hypotension may cause accidental falls. [11] It is also linked to an increased risk of cardiovascular disease, heart failure, and stroke. [42] [27] Also, observational data suggest that orthostatic hypotension in middle age increases the risk of eventual dementia and reduced cognitive function. [43]
Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
In addition to orthostatic hypotension, supine hypertension, where the BP is excessively high lying down, is a frequent problem in multiple system atrophy. Treatment of one symptom can easily aggravate the other, and supine hypertension in such patients has been linked to the same cardiovascular complications as essential hypertension .
Causes range from non-serious to potentially fatal. [1] There are three broad categories of causes: heart or blood vessel related; reflex, also known as neurally mediated; and orthostatic hypotension. [1] Issues with the heart and blood vessels are the cause in about 10% and typically the most serious while neurally mediated is the most common. [1]
Orthostatic vital signs are also taken after surgery. [7] A patient is considered to have orthostatic hypotension when the systolic blood pressure falls by more than 20 mm Hg, the diastolic blood pressure falls by more than 10 mm Hg, or the pulse rises by more than 20 beats per minute within 3 minutes of standing [5] [7]
Within three minutes of standing up straight, orthostatic hypotension is defined as a drop in systolic blood pressure of at least 20 mm Hg or a drop in diastolic blood pressure of 10 mm Hg. [7] About half of PAF patients also have concurrent supine hypertension, even though all PAF patients by definition have orthostatic hypotension. [8]
Aortocaval compression syndrome may cause syncope, restlessness, dizziness, headache, tinnitus, visual disturbances, numbness or paresthesia of the limbs, abdominal/chest discomfort or pain, nausea, and vomiting. [4] Some patients may be asymptomatic. [5]
Superior mesenteric artery compressing the duodenum, featuring the superior mesenteric artery syndrome. Superior mesenteric artery (SMA) syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery.